Airdrop Sacrifice Pledge to                                    SENS Research Foundation
Please fill out this form to make your pledge PRIOR to making your donation to SRF. Once completed, we will have your information and you may make your donation. Send us an email at Airdrop@sens.org after you've completed the donation to expedite the confirmation process. You can find out how to make your donation at www.sens.org/donate.
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Email Address *
Method of Donation *
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What exactly are you donating? (amount and currency, NOT USD value) *
Your public wallet address for receipt of Pulse reward *
If you are donating via cryptocurrency, is the wallet you are SENDING from, decentralized and/or non-custodial?
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If you are donating crypto AND you answered YES above, please provide your source address for verification purposes (if different from your provided wallet address above).
If you are donating crypto AND you answered NO above, please create a random 3 digit number to include in your donation and document it here.
Your name (optional) if you want a tax receipt.
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